Georgia Medicaid Book, Chapter 2 – Eligibility Basics

(Last Updated 8/23/2021)

Proving eligibility for Medicaid means checking every box to establish eligibility under the class of assistance the applicant seeks. The basic requirements are discussed in this chapter. Although financial eligibility criteria are a significant part of the planning and application process, they are discussed in later chapters.

 

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Cash, Bank Accounts and Non-retirement Investments and Medicaid

Cash and Accounts Monetary resources can typically be liquidated within 20 days. These include cash, savings accounts, checking accounts, money market accounts and the like. Medicaid always “counts” monetary assets when determining Medicaid eligibility. Specifically, 20 C.F.R § 416.1201(b) provides: “Liquid resources are cash or other property which can be converted to cash within 20 […]

Government Bonds and Medicaid

Government Bonds are debt instruments issued by a government entity. The most common form of government bond owned by a Medicaid applicantis U.S. Savings Bonds. Savings bonds are not transferrable. They can only be sold back to the government. If they are owned solely by the applicant or the applicant’s spouse, they are countable. However, […]

Vehicles and Medicaid

General Rule One vehicle of any value is exempt. If the applicant has more than one vehicle, then the most valuable vehicle will be exempt and other vehicles will count toward the $2,000 resource limit. In Georgia, “Automobile” means any vehicle used for transportation. These include cars, trucks, motorcycles, golf carts, animal-drawn vehicles and animals. […]

POMS Provisions Regarding Property Rights

POMS SI 01120.010 provides that an individual must have some form of ownership interest in property in order for the property to be considered a resource. [For presumably liquid resources (SI 01110.305), assume that the person whose name is shown as owner owns the entire resource. If more than one owner is shown, assume that […]

Property Rights

Assets are things you own that have value. Assets include all income and all resources. 42 U.S.C. § 1396p(h)(1).  They are one-half of a net-worth calculation (the other half being liabilities). Medicaid treats different types of assets differently, with some being countable and others being non-countable (or exempt) during the eligibility determination. Recall that you […]

Divorce and the Community Spouse

Another “option” that may be considered in appropriate cases is divorce. Deeming between spouses terminates when the marriage terminates. In most cases, this “option” should be avoided because the emotional turmoil associated with divorce is significant and the CSRA can be set by court order, see § 1396r-5(f)(2)(iv) and (f)(3). Divorce also prevents an applicant […]

Seeking Adjustments to the CSRA or MMMNA

MCCA includes a mechanism for increasing both the CSRA and the MMMNA in certain cases. The methods by which this can be effected are described in 1396r-5(e), (d)(5) and (f)(3). Blumberg v. Tennessee Department of Human Resources, 2000 WL 1586454 (Tenn.Ct.App.) was a case where a Community Spouse sought a court adjustment of the default […]

Post-Eligibility Treatment of the Institutional Spouse’s Income

As eligibility is being determined, if the Community Spouse’s monthly income falls below the Minimum Monthly Maintenance Needs Allowance (“MMMNA”), then MCCA contemplates two methods of raising her income up to the MMMNA. First, a portion of the Institutionalized Spouse’s income may be transferred to her to bring her income up to the MMMNA. Second, […]

Protecting Income for the Community Spouse

Income and resources are treated differently. Unlike resources, income is not pooled in determining eligibility; the Community Spouse’s separate income is never considered available to the Institutionalized Spouse. Thus, the standard income eligibility process for one person applies. First, all income earned by the Community Spouse is always unavailable to pay nursing home bills, regardless […]

Potential Redetermination When Moving to a New State

In Dullard v. Minnesota Department of Human Services, 529 N.W.2d 438, 443 (Minn. App. 1995), Minnesota was allowed to reevaluate eligibility after a couple moved from Illinois to Minnesota. There, Illinois (like Georgia) allowed the Community Spouse to keep the maximum CSRA, while Minnesota (like Tennessee) applied a formula resulting in a lower CSRA. The […]

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